One of the assumptions in the Affordable Care Act (ACA, or if you prefer, ObamaCare) was that increased preventative care is an important aspect of lowering medical costs, since it generally costs less to prevent disease than it does to treat it.
Regardless of your comfort level with medicine or your political leanings, it is difficult to argue that point – although it appears to be easy to argue what constitutes preventative care, and even easier to argue about how to pay for it….
Even so, ObamaCare does mandate that a significant list of preventative care services must be covered by qualifying health care plans, without any out-of-pocket costs. These services are covered whether or not you have met your deductible. As long as you stay within the network of your plan, there are also no co-pays or co-insurance.
A dwindling number of plans that were given "grandfathered" status do not have to provide these services without co-payment or co-insurance, but these plans are likely to continue to die off or lose their grandfathered status within the next few years.
A comprehensive list of preventative services may be found at www.healthcare.gov and other websites, but we will summarize some of the more important ones below by category.
- For All Adults – A basic, annual health care checkup is provided at no cost. So is screening for blood pressure, cholesterol, Type 2 Diabetes, HIV, obesity, depression, colorectal cancer, and sexually transmitted infections (STIs), as well as syphilis.
Counseling services are included for alcohol and tobacco use, STIs and obesity. Basic immunizations are also covered, including flu shots.
- For Women – Specific services for women include breast cancer services (screening, genetic test and chemoprevention counseling), domestic violence counseling, and a wide variety of screenings, from osteoporosis to cervical cancer to HIV, syphilis, and gonorrhea.
Pregnancy-related services include anemia and gestational diabetes screenings, breastfeeding assistance programs, and folic acid supplements.
Contraception coverage is included with methods that are approved by the FDA (Food and Drug Administration), along with sterilization, counseling, and educational services. While the fight rages on, currently those who fall under a Religious Employer Exemption (REE) do not have to cover contraceptive services.
- For Children – Vaccines are covered from birth to the age of 18, which can be an extremely expensive component. There may be those who will still refuse treatment believing that vaccines are harmful, but under ObamaCare, cost cannot be used as an excuse.
A large number of screenings are covered, including newborn screens for hearing and vision problems and specialized diseases such as hypothyroidism and PKU (phenylketonuria), autism screening during 18 and 24-month checkups, developmental screening, and obesity screening.
Basic assessments such as blood pressure screening, physical measurements (height/weight and body mass index), and oral health risks are covered throughout the childhood years. For adolescents, services such as depression screening, alcohol/drug assessments, and screenings for HIV and cervical dysplasia are covered.
It is wise to take advantage of all of these preventative benefits to which you are entitled, especially your free annual checkup. Even if you have a strong negative opinion of ObamaCare, it is foolish to not take advantage of preventative care.
While there are still fights to repeal or modify ObamaCare, preventative measures are generally not part of the main argument (contraception excepted). It seems likely that we will have several years of data on which to evaluate the preventative care aspects of ObamaCare – and perhaps have more evidence to quantify how much money is actually saved through these programs.